Diverticulitis/diverticulosis

[geomannie]

Hi

Last year after a short cycle tour I developed severe abdominal pain and was diagnosed with diverticulitis, an acute phase of diverticulosis. I was on the road to developing full-blown peritonitis but 5 days in hospital on IV antibiotics and 3 weeks of heavy duty oral antibiotics knocked it on the head.

At the time I was told that most people never get another bout of diverticulitis but a couple of weeks ago I had grumblings, not as severe as the first time, and am back on oral antibiotics and associated dietary control.

Whilst I don't think that this is cycling-related, it certainly puts me off my cycling. Has anyone else had similar problems? How does this go long-term? I am told that there is a surgical option (removal of a section of sigmoid colon) but that is something I do not want to contemplate just yet.

Thanks for any experiences you can share.

[AMMoffat]

Not direct experience but my father had diverticular disease. He controlled his by ensuring he ate a high fibre diet and, in particular, consuming a tablespoon of bran with his breakfast every day. Not the most appetising thing, but it seemed to work for him in preventing flare-ups.

[thirdcrank]

This isn't experience but in the absence of very much from anyone else, I'll offer some ideas.

AFAIK, the accepted cause of your illness is poor diet, specifically inadequate amounts of fibre, what we once called roughage. The human gut can develop little stagnant spots when food isn't all squeezed on its way during digestion. A part of the gut then goes septic. Antibiotics may be able to cure the inflammation if it's not gone too far, but with the same diet, there's always the chance of a repeat.

So, I believe that if a full cure is achieved with antibiotics or surgery, then a better diet should considerably reduce the likelihood of any recurrence.

[geomannie]

Hi Folks,

Thanks for your thoughts. I fully understand about roughage and all through my life have made sure to include a lot of whole grains, fruit and veg in my diet. And still I developed diverticulosis, plus a relapse 11 months later despite upping my fibre intake . I am interested in stopping it flaring up again and some sort of long-term management plan. Thanks for any pointers anyone can give me.

[Cyril Haearn]

There may be other causes. Maybe you are even eating too much roughage, or the wrong sorts. Could be worth experimenting, trying other foods. I have porridge every day, digestion seems to work very well. It is worth trying to stop eating several hours before going to bed, then the digestion has time to work, I think it slows down while one sleeps

An old proverb: breakfast like a king, lunch like a farmer, supper like a beggar

[eileithyia]

It might also be worth talking to your GP / consultant / get a dietician referral to discuss management.

[velotrev]

I have also been diagnosed with diverticular disease and have had two bouts of diverticulitis this year, the latter I am just getting over now. Despite changing my diet (which I thought was OK before). I think the latest bout was caused by getting dehydrated whilst away working, and during the long drive.

So if your bouts are after cycling any sort of distance it could be down to poor rehydration. I have been cycling for over 45 years and must admit that I am not the best at keeping rehydrated, so wouldn't be at all surprised if that's why I am now suffering!

[ambodach]

I got a severe attack of diverticular problems about 20 years ago and was rushed straight from my GP surgery to hospital. I was on IV antibiotics and had a blood transfusion. Since then I have had about 4 or 5 "warnings" but I now have a supply of co-amoxclav which I keep handy and as soon as a pain which I recognise appears I start on this at once. This has so far been successful in nipping it in the bud fairly quickly and seems to have the approval of any doctor I have seen. This is penicillin based of course but you could try your GP. Best to ask the pharmacy also for a supply with a long use by date if you get it. Last week I had another attack with dark blood but no pain so a locum decided it was not diverticular but gave me some co-amoxyclav as a precaution.This seems to be working but I am now referred to hospital for the usual unpleasant scope to find out what is going on. It seems to be one of these things which you have to manage as best you can and diet does help but is not the full answer. Good luck anyway.

[softlips]

I have also been diagnosed with diverticular disease and have had two bouts of diverticulitis this year, the latter I am just getting over now. Despite changing my diet (which I thought was OK before). I think the latest bout was caused by getting dehydrated whilst away working, and during the long drive.

So if your bouts are after cycling any sort of distance it could be down to poor rehydration. I have been cycling for over 45 years and must admit that I am not the best at keeping rehydrated, so wouldn't be at all surprised if that's why I am now suffering!

I'd agree, diverticulor diesease affects the sigmoid colon where water is absorbed. Any dehydration will cause more water to be absorbed and thus slower movement of faeces through the colon resulting in an increased risk of faeces remaining in the little pockets and irritating them causing diverticulitis.

Drink plenty before riding and sip every ten minutes once out. It's worth a try. Although you will have to stop more no doubt.

[Flinders]

re fibre- I take a little prune juice every day, with my main meal. It looks like pureed sewage, and tastes totally disgusting, but I have found it very good for the digestion since taking it after some abdominal surgery years ago when the old guts were not recovering very well from the anaesthetic; so much so I have taken it ever since. Worked far better than the traditional sugar syrup they give you.

It was about three years before I could drink it without holding my nose, and I still keep it chilled to mask the taste. I take Sunsweet, as some other versions have a lot less fibre in. It might be worth a (cautious) try for anyone who finds bran is the wrong sort of roughage for them.

A word of caution though- I only take about an inch or two in the bottom of a glass, not a big glassfull. I'd be wary of overdoing it, especially if you have a specific problem, which I don't. I recall someone saying after my surgery to take this or the sugar syrup, not both, 'unless you have no plans for the rest of the day'.

[ambodach]

Following on from my last post I got " done" at both ends today. Colonoscopy was quite painful even with sedation and painkillers. Consultant said it was the worst case of diverticulitis he had seem but nothing sinister found so a mixed result. Apparently a blood vessel probably ruptured but fortunately stopped spontaneously with no intervention. Seems to be nothing can be done except perhaps cut out bits of bowel which is quite a big op and at my advanced age mebbe not worth the hassle. We all have to die sometime and there is little to keep me here now except my cycling trips.Worries me a bit as it may curtail my camping trips. I do not fancy waking in a tent on Barra with the same problem again and having to get home quickly or get medical help there which means a plane to Glasgow. Diet seems the only partial solution.

[alimck]

I recently had a bout of diverticulitis which as in your case was sorted with IV antibiotics then oral antibiotics. Until I had a colonoscopy shortly afterwards, I'd had no idea I had underlying diverticulosis. (I've been told that 60% of over-60's have it but don't know unless it flares up) It's really important to keep things moving so bad bacteria don't get a hold. Here's what I do to avoid a recurrence:
Prescribed Fybogel fibre supplement -- excellent
Hefty pro-biotic supplement Super 20 Pro online from Healthspan (promotes 'good' bacteria)
PRE-biotic supplement Inulin online from Peak Supps to facilitate action of the above
Lots of fibre
Lots of liquids
I don't usually need the Fybogel if I use the supplements.

[horizon]

May I ask if any of the sufferers are vegetarian (I'm not trying to make a point by the way)?

[geomannie]

May I ask if any of the sufferers are vegetarian (I'm not trying to make a point by the way)?

No but I for all my life I have eaten a lot of fruit, veg and whole grains. My mother has diverticulosis and my guess is that there is a heritable element.

[velotrev]

I am not vegetarian. I don't eat a lot of meat though. I have increased my intake of fruit and veg, and also use Fybogel to increase my fibre intake. Only a few weeks ago having returned from holiday, I let my diet fall into old habits, and wasn't getting enough fibre, lo and behold got struck down with another bout of diverticulosis. Lesson learned.